Walsh & Hoyt: Cerebral Venous Thrombosis: Outcome

The prognosis following CVT is variable, ranging from complete recovery to death. Older series reported a mortality of 3050% but more recent studies indicate a generally favorable outcome in the large majority of patients. In some reports this improved outcome has been attributed to earlier diagnosis and more widespread treatment with heparin, however one prospective univariate analysis showed no difference in outcome between those patients who were heparinized and those managed supportively. Studies of outcome that assess just mortality and independent status following CVT portray a more positive prognosis than those that record residual symptoms, neurologic and cognitive deficits, and ability to return to premorbid activities. Thus an overall good outcome was reported in 8287.5% of patients following CVT in four separate studies. However, Breteau et al. found residual symptoms in three-fourths of 48 survivors, including seizures in 7, motor deficits in 6, visual field loss in 5, and chronic headaches in 29. In another study of patients who regained independence at least one year after a CVT, 29% had persistent cognitive impairments and 40% could not resume their previous level of economic activity. In a follow-up study of 34 patients who had suffered a CVT several years earlier, 10 suffered from persistent headaches and 3 had seizures, but none were found to have residual functional disability.